脑卒中合并轻度认知障碍患者脑血流图参数与认知功能的关系

The relationship between cerebral blood flow parameters and cognitive function in stroke patients with mild cognitive impairment

目的探讨脑卒中合并轻度认知障碍患者脑血流图参数与认知功能的关系。方法选取本院2021年1月~2023年9月本院收治的45例脑卒中合并轻度认知障碍患者纳为合并组,另选取45例脑卒中患者纳为未合并组。检查并比较两组患者单光子发射计算机断层(Single Photon Emission Computed Tomography,SPECT)脑血流灌注参数(额叶、颞叶、顶叶、枕叶、丘脑、基底节左右侧),另外评估其蒙特利尔认知评估表(Montreal Cognitive Assessment,MoCA),最后通过Spearman秩相关分析脑卒中合并轻度认知障碍患者脑血流灌注参数与MoCA评分的相关性。结果合并组右侧额叶、左侧丘脑以及双侧颞叶、顶叶、枕叶血流灌注参数低于未合并组,差异有统计学意义(P<0.05);合并组MoCA评分(23.56±2.12)低于未合并组(27.24±1.16),差异有统计学意义(t=10.215,P=0.000);脑卒中合并轻度认知障碍患者右侧额叶、双侧颞叶以及左侧顶叶与MoCA评分呈正相关(P<0.05,Bonferroni校正)。结论脑卒中合并轻度认知障碍患者存在脑血流灌注参数异常,且右侧额叶、双侧颞叶以及左侧顶叶脑血流灌注参数与认知功能呈正相关,临床医师应密切监测。

Objective To explore the relationship between cerebral blood flow parameters and cognitive function in stroke patients with mild cognitive impairment.Methods 45 stroke patients with mild cognitive impairment admitted to our hospital from January 2021 to September 2023 were selected as the combined group,and another 45 stroke patients were selected as the non-combined group.Check and compare the cerebral blood flow perfusion parameters(frontal lobe,temporal lobe,parietal lobe,occipital lobe,thalamus,basal ganglia left and right)of two groups of patients using single photon emission computed tomography(Single Photon Emission Computed Tomography,SPECT).Additionally,evaluate their Montreal Cognitive Assessment Form(Montreal Cognitive Assessment,MoCA).Finally,analyze the correlation between cerebral blood flow perfusion parameters and MoCA scores in stroke patients with mild cognitive impairment using Spearman rank correlation analysis.Results The blood flow perfusion parameters of the right frontal lobe,left thalamus,and bilateral temporal,parietal,and occipital lobes in the combined group were lower than those in the non-combined group,with statistical significance(P<0.05).The MoCA score of the combined group(23.56±2.12)was lower than that of the non-combined group(27.24±1.16),and the diference was statistically significant(t=10.215,P=0.000).The right frontal lobe,bilateral temporal lobe,and left parietal lobe of stroke patients with mild cognitive impairment were positively correlated with MoCA score(P<0.05,Bonferroni correction)Conclusion Patients with stroke combined with mild cognitive impairment have abnormal cerebral blood flow perfusion parameters,and the cerebral blood flow perfusion parameters in the right frontal lobe,bilateral temporal lobe,and left parietal lobe are positively correlated with cognitive function.Clinicians should closely monitor.